HCPCS 97161

Other service (ClaimLight category; the code descriptor is not shown)

Other services Work RVU per service 1.54 (2022 fee schedule)

34,013
99th percentile among 6,326 codes billed · 2022
$107M
98th percentile among 6,326 codes billed · 2022
1.4M
96th percentile among 6,326 codes billed · 2022
31
60th percentile among 6,326 codes billed · 2022
110
57th percentile among 6,326 codes billed · 2022
+5.2%
Medicare payment on the code vs 2021; billers +5.8% · 2022

Trend

Medicare payment on the code

$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M$0$50M$100M2020: $68M paid20202021: $102M paid20212022: $107M paid20222023: $114M paid20232024: $115M paid2024$115M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K020K40K2020: 28K providers20202021: 32K providers20212022: 34K providers20222023: 36K providers20232024: 37K providers202437K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
202437,020$114,914,966+1%1,576,730311111.54
202335,745$113,952,457+6% (2023 changed hospital and observation visit codes)1,533,616311121.54
202234,013$107,363,788+5%1,439,378311101.54
202132,148$102,028,201– (Not compared: 2021 changed office visit values)1,336,170311071.54
202027,736$68,010,739first year in data1,071,37529991.20

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
California3,185$11,844,354151,12334125
New York2,962$10,962,057132,70434115
Florida1,682$7,715,940103,81840181
New Jersey1,599$4,861,06259,9773089
Illinois1,489$4,666,80461,53131102
Texas1,373$3,975,29355,12628106
Massachusetts1,120$3,609,59145,88432108
North Carolina1,147$3,543,55649,80232108
Pennsylvania1,300$3,537,90347,6412990
Arizona997$3,516,06349,39234140
Virginia1,034$3,444,96945,77333114
Maryland917$3,364,52442,04836116
Washington1,141$2,898,04139,7122690
Georgia775$2,401,24733,73033113
Ohio736$2,281,94732,26134109

Not listed: 5 billers with an armed-forces or unknown state code (AA, AE, AP, XX); they are in the national totals.

Not listed: 2 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,419$12,290,525145,76933
Los Angeles-Long Beach-Anaheim, CA1,056$3,546,85444,60530
Chicago-Naperville-Elgin, IL-IN1,167$3,509,96245,47229
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD922$2,683,61034,26329
Miami-Fort Lauderdale-West Palm Beach, FL495$2,582,17033,93541
Washington-Arlington-Alexandria, DC-VA-MD-WV827$2,577,59931,79129
Boston-Cambridge-Newton, MA-NH860$2,537,43831,99729
Phoenix-Mesa-Chandler, AZ707$2,347,48832,90133
Baltimore-Columbia-Towson, MD399$1,351,27417,12632
San Francisco-Oakland-Fremont, CA334$1,311,35515,58032
Seattle-Tacoma-Bellevue, WA573$1,274,63017,00523
Dallas-Fort Worth-Arlington, TX441$1,216,57616,60125
Minneapolis-St. Paul-Bloomington, MN-WI558$1,202,52316,63027
Atlanta-Sandy Springs-Roswell, GA443$1,195,83716,36929
Providence-Warwick, RI-MA360$990,54912,85428

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing 97161 nationally

Physical Therapist in Private Practice accounts for 98% of payment for 97161 nationally in 2022, across 12 specialties on claims.

observed calculated calculated calculated calculated calculated
Physical Therapist in Private Practice33,30198%$105,001,94598%1,408,27142
Orthopedic Surgery3881.1%$1,267,0761.2%16,64043
Physical Medicine and Rehabilitation1060.31%$376,5080.35%4,89146
Internal Medicine170.05%$149,5350.14%2,058121
Family Practice290.09%$102,1750.10%1,39948
Otolaryngology260.08%$66,4850.06%89634
Podiatry210.06%$56,1580.05%69633
Neurology190.06%$53,2390.05%67836
Sports Medicine110.03%$48,0810.04%62056
Interventional Pain Management140.04%$45,7990.04%59543
Neurosurgery140.04%$34,0900.03%43931
Rheumatology110.03%$30,2080.03%38335

Not listed: 13 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2022.

Top billers of 97161 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations